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The use of cannabis is often associated with increased relaxation, reduced stress, and an improved sense of happiness. Consequently, individuals battling depression or anxiety are more inclined to turn to cannabis as a potential remedy, sometimes in combination with prescription antidepressants like Zoloft, Prozac, and Wellbutrin. Given this common practice, it becomes crucial for both medical professionals and patients to gain a comprehensive understanding of the potential interactions that might occur when these substances are used together.
Extensive research has revealed the therapeutic potential of cannabis in addressing various medical conditions. If you’re considering integrating cannabis into your medical treatment plan while residing in Naperville, obtaining a medical marijuana card Naperville is a legal prerequisite for the consumption of cannabis.
Surprisingly, despite extensive research on the connections between cannabis use and psychiatric disorders, there is a notable shortage of rigorous studies focusing on the intricate interplay between cannabis and antidepressants. Extensive searches on platforms like Google Scholar and the National Institutes of Health PubMed website yield few relevant studies on this subject. Even the National Institute on Drug Abuse (NIDA) website provides limited information regarding this intriguing and complex topic.
One of the challenges confronting physicians when prescribing antidepressants to patients who also engage in cannabis (or other substance) consumption is determining the appropriate dosage. Concurrent cannabis use can hinder their ability to accurately assess the effectiveness of antidepressants.
Physicians emphasize that one of the key variables, when patients combine multiple substances, is the difficulty in measuring the extent to which each substance produces side effects and impacts behavior and mood. Naturally, the more substances a patient combines, the more challenging it becomes to isolate the results of each substance. This is why physicians often initiate treatment with one drug and consider adding others later.
Allan Schwartz, LCSW, Ph.D., a psychotherapist and licensed clinical social worker practicing in Colorado and New York, has observed that, especially in severe cases, patients may need to temporarily abstain from cannabis and other substances when undergoing treatment for depression or anxiety that involves antidepressants.
There is also evidence suggesting that patients with depression are more inclined to misuse cannabis or transition from occasional to chronic use. In fact, individuals suffering from anxiety or depression are found to use cannabis at rates ranging from two to eight times higher than those without these conditions.
Anecdotally, many physicians have observed that some patients who use cannabis, alcohol, or other drugs during their treatment, particularly those with severe depression or bipolar disorder, are less likely to adhere to their treatment plans. This includes prescription medications and behavioral interventions like cognitive behavioral therapy and psychotherapy. Schwartz has witnessed patients frequently going on and off their medication regimens, often with dire consequences.
Beyond these general concerns, it’s important to recognize that each class of antidepressants carries its own distinct set of side effects and possible interactions. Drawing from an analysis of scientific literature, we’ve compiled a concise overview of the most prevalent antidepressant classes and their associated risks.
Selective Serotonin Reuptake Inhibitors (SSRIs) stand as the most frequently prescribed medications for treating depression. Patients often report fewer side effects and drug interactions when compared to many other antidepressant categories. Some well-known SSRIs include:
Although adverse interactions with cannabis are infrequent, there have been isolated case reports speculating that combining cannabis and SSRIs might slightly elevate the risk of hypomania (a mild form of mania), particularly in vulnerable populations such as individuals with bipolar disorder. However, on the whole, many physicians favor SSRIs due to their relatively low occurrence of adverse interactions with other medications.
SNRIs, a more recent class of antidepressants, are seldom associated with adverse interactions with cannabis or other drugs. Common SNRIs include:
NDRIs are noteworthy for being among the few antidepressants that typically do not cause sexual side effects. They are also occasionally prescribed for conditions like ADHD and smoking cessation. Some commonly used NDRIs include:
Reports of adverse interactions between NDRIs and cannabis are exceedingly rare.
Despite an extensive search for case reports on PubMed regarding adverse interactions between cannabis and MAOIs, no relevant results were found. Nevertheless, due to the well-documented high-risk profile of MAOIs, which can lead to significant side effects and potentially life-threatening interactions with various foods and medications, the use of cannabis alongside MAOIs is strongly discouraged.
MAOIs have lost popularity in treating depression due to their reported side effects and the dangerous interactions they can induce, some of which can be fatal. Common MAOIs include:
One notable case report involves a 17-year-old boy who was prescribed 25mg of amitriptyline for his depression and insomnia. Upon investigation, it was revealed that the only other substance he had been using was cannabis. He was subsequently admitted to the ER due to a rapid heartbeat (tachycardia).
The attending physician underscored the potentially life-threatening nature of adverse interactions and advised against prescribing tricyclic antidepressants for the treatment of depression or insomnia in patients who use cannabis or other drugs. Similar concerns have been reported in other case studies.
While tricyclic antidepressants tend to result in fewer reported side effects and interactions compared to MAOIs, they are associated with more undesirable side effects than newer antidepressant options. As a result, they are typically reserved for patients who have not responded to other treatment approaches.
Common tricyclic antidepressants include:
While sedatives are not classified as antidepressants, they are often prescribed to individuals experiencing depression. Both cannabis and sedatives have the potential to induce drowsiness or sleepiness, a common side effect associated with sedative medications. Combining cannabis with these sedative medications can intensify these effects.
From a pharmacological perspective, the likelihood of adverse interactions between cannabis and antidepressants (with some notable exceptions) appears relatively low.
However, other important considerations include the possibility that antidepressants may become less effective or take longer to produce results. Patients may also be at a higher risk of discontinuing their treatment regimens, which could prolong their recovery. Additionally, individuals with depression have an elevated risk of transitioning from moderate cannabis use to problematic use.
For individuals grappling with severe depression or bipolar disorder, these risks are even more substantial. It is imperative for individuals to carefully weigh these factors and exercise moderation in their cannabis use.
Common sedatives include:
Seeking guidance from your MMJ doctor is strongly recommended when considering the inclusion of medical cannabis in your treatment plan.
